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GPs under pressure as PCOs put squeeze on prescribing bills

Pulse investigation reveals scale of moves to clamp down on prescribing statins

GPs are facing stringent curbs on their prescribing in a desperate bid by primary care organisations to rein back deficits.

More than nine in 10 PCOs are now implementing schemes to switch patients en masse to generic simvastatin, a Pulse investigation reveals.

Strategic health authorities are going even further than the official Government line, with one demanding that at least 80 per cent of statin scripts be simvastatin or pravastatin.

GPs told Pulse that while they understood the need to control costs, trusts were putting doctors under excessive pressure to restrict prescribing.

Cash-strapped PCOs are even threatening GPs with charges of 'excessive prescribing' and breach of contract for use of a series of locally blacklisted drugs (see story below).

The findings come after the Department of Health released a new analysis suggesting the NHS could save £85m a year if 69 per cent of statins were simvastatin or pravastatin.

East of England SHA is now demanding 80 per cent of statin prescriptions are simvastatin or pravastatin, with some trusts in other areas adopting the same target.

Pulse's survey of 50 PCOs found 92 per cent now had statin switching schemes in place for existing patients.

The schemes have already had an impact on prescribing. The proportion of patients on simvastatin or pravastatin rose from 61.6 per cent in November 2005 to 68 per cent a year later, according to figures obtained by Pulse from Cegedim Strategic Data.

Northamptonshire PCT reported savings of £1m a year with the implementation of its switching scheme.

Dr Richard Wright, chair of North Essex LMC, said: 'Locally we have strong pressure to move people from atorvastatin to simvastatin. I think it's up to doctors how they deal with it, but it's an increased workload on GPs.'

Dr Nigel Watson, chair of Wessex LMC, said: 'Some PCTs have said "you've got to reach a specific percentage or we'll look at a breach of contract". That's not the way to get things done.'

Dr George Kassianos, a GP in Bracknell, Berkshire, said: 'PCTs are cutting down and trying to economise on every front.

'The first statin we need to use is simvastatin 40, but if this does not deliver the clinical [JBS2] target we are aiming for, the next is rosuvastatin 10 in cost effectiveness.'